Botulinum toxin, most widely known as Botox, is believed to be a miracle cure to remove wrinkles and provide people with smoother-looking skin. But all is not what it seems.

Botox is actually the name of just one brand of botulinum toxin, although it has gained popularity as a general term to describe the product.

There are many unlicensed clinics providing Botox injections and also some questionable cosmetics sold online claiming they contain Botox boosting qualities in their products. Yet medical experts have warned people not to go to unlicensed clinics to receive Botox injections and highlighted that no cosmetics are allowed to contain Botox.

“Botulinum toxin is a neurotoxic protein and is only allowed to be used by licensed facilities and professional doctors. It also must be strictly stored and managed as toxic medicine, so people can’t buy it from the market directly,” said Dr Li Yufei, director of plastic surgery department of the No.455 Hospital of Chinese People’s Liberation Army in Shanghai. “Any Botox bought outside a licensed hospital and clinic is illegal — either smuggled or fake.”

Experts said the cosmetic application of botulinum toxin is because the injection into the muscles under wrinkles can block the information transformation between nerves and muscles, causing relaxation of those muscles and resulting in the smoothing of the skin.

The treated muscles gradually regain function and return to their former appearance in months. So the muscles should be treated repeatedly to maintain the smoothed appearance.

“There are only two legal botulinum toxin products in China. The one branded Botox from Allergan Pharmaceuticals Ireland and domestic brand Hengli produced by Lanzhou Biological Product Institute. The price is about 2,000 yuan (US$303) each dose for the imported one and 700 yuan for the domestic one,” Li said.

“If the price is much lower, people should arouse their awareness to question the source. Moreover, one dose only can be used for one patient. It is not allowed for sharing between patients for safety concern.”

The China Food and Drug Administration has issued a warning, alerting the public not to receive botulinum toxin injection in unlicensed facilities after some people suffered serious side effects after receiving injection from non-medical facilities.